Preventive Medicine Associates

Organization Active NPI Addiction Medicine (Family Medicine) Physician · Brookline, MA

NPI 1962451591 · NPPES record last updated May 22, 2008

Key facts

NPI
1962451591
Entity type
Organization (NPI type 2)
Primary specialty
Addiction Medicine (Family Medicine) Physician 207QA0401X
Legal business name
PREVENTIVE MEDICINE ASSOCIATES
Practice address
11 Kent St
Brookline, MA 02445-7901
Phone
(617) 383-6405
NPI assigned
May 10, 2006
Organization subpart
No

Authorized official

Name
Dr. Punyamurtula Kishore, M.D.
Title
Director
Phone
(617) 383-6567

Practitioners 87

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 87

National Provider Directory

Locations

11 Kent St
Brookline, MA 02445
Phone (617) 383-6405

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207QA0401X Yes

Addresses

Primary practice location

11 Kent St
Brookline, MA 02445-7901

Mailing address

11 Kent St
Brookline, MA 02445-7901
Phone (617) 383-6405

Other identifiers

IdentifierTypeStateIssuer
9772898MedicaidMA

Other providers in Brookline, MA

All providers in Brookline, MA · Addiction Medicine (Family Medicine) Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.